March 3, 2016
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IN THIS ISSUE:
New feature – MACRA news
The AHA's Physician Leadership Forum News & Updates is debuting a new column on the Medicare Access and CHIP Reauthorization Act (MACRA) and what it will mean for physicians and hospitals as payment system changes are implemented. Each month, this column will feature news and resources to help you and your organization prepare for the MACRA changes coming in 2019. The American Hospital Association (AHA) also created a webpage, www.aha.org/MACRA with a suite of resources, including an issue brief, webinar, articles and a timeline to share with physicians and hospital leaders. The Centers for Medicare & Medicaid Services (CMS) has stated that it intends to begin rulemaking on the physician payment changes this spring.
 
Earlier this week, AHA urged CMS to ensure that quality measures for the Merit-Based Incentive Payment System (MIPS) and alternative payment models for physicians align with national priorities for the entire health care system. Commenting on the draft measure development plan, Ashley Thompson, AHA senior vice president for public policy analysis and development, also urged CMS to release more information about its measure development pipeline; support development of a MIPS reporting option for hospital-based physicians; and adjust existing and future measures if needed to reflect the impact of sociodemographic factors. Among other comments, AHA applauded the plan's comprehensiveness and voiced support for several of its goals, strategies and priorities.
 
In addition to these resources, AHA is collaborating with the American Medical Group Association (AMGA) to create an opportunity for members to participate in a learning fellowship on managing population health and succeeding in the new physician payment models that take effect in 2019. Details are included in the item below and the call for participation is available at www.ahaphysicianforum.org/fellowship.
AHA and AMGA Announce Learning Fellowship: Creating Clinically Integrated Health System-based Medical Groups
The AHA's Physician Leadership Forum is collaborating with AMGA to create an opportunity for members to participate in a learning fellowship on managing population health and succeeding in the new physician payment models that take effect in 2019. The call for participation is available at www.ahaphysicianforum.org/fellowship.
 
The AHA-AMGA Learning Fellowship is a comprehensive program that addresses critical success factors such as leadership, culture, structure, execution, alignment, reimbursement, and physician compensation. Working together, we will provide participating organizations and their employed physicians with the skills and information to move from a traditional hospital-owned/employed model to a more organized, integrated system of care delivery for the purpose of managing population health. The fellowship will begin in July 2016 and end in October 2017. Submissions are due April 8, 2016.
 
To apply download the application, or for additional information, contact Elisa Arespacochaga at 312-422-3329 or elisa@aha.org.
ASPR releases new Zika resource
The U.S. Department of Health and Human Services' Office of the Assistant Secretary for Preparedness and Response has released a new comprehensive resource on Zika virus for clinicians and emergency response personnel. Zika: Resources at Your Fingertips includes an overview of the virus – its epidemiology, symptoms, where it is found and how it is transmitted – as well as considerations and resources for health care providers broken out by profession/facility. The guide will be updated as new information or guidance emerges. For the latest on Zika, visit www.cdc.gov/zika and www.aha.org/zika.
 
In related news, the Cleveland Clinic Journal of Medicine has published an article that summarizes the state of the Zika virus, including what is currently known about it, who is most at risk, what clinicians can tell their patients, and where to find updates and additional information.
New initiative aims to improve antibiotic prescribing in the outpatient setting
In an effort to improve antibiotic prescribing, the United Hospital Fund (UHF) has launched its Outpatient Antibiotic Stewardship Initiative. UHF is providing over $350,000 to nine hospitals and health systems in the New York area to support their involvement in the initiative, helping them develop and implement approaches to antibiotic stewardship. UHF will work with a total of 28 hospital outpatient sites and analyze prescribing practices for adult patients with acute respiratory infections. In a press release, Hillary Jalon, UHF director of quality improvement, said, "Antibiotic resistance is a growing national concern, and focusing on antibiotic-prescribing practices in outpatient settings offers a unique opportunity to make a difference. We hope that our work will shed new light on the topic, create practical tools that providers can use in their practices, and contribute to meaningful change in New York and across the country."
Behavioral interventions help reduce inappropriate antibiotic prescribing, study suggests
Two behavioral interventions could be the key to reducing inappropriate antibiotic prescribing for acute respiratory tract infections, according to a recent article (abstract only) in JAMA. Researchers studied the effects of three behavioral interventions used alone or in combination:
  • Suggested alternatives where, when entered into an electronic health record (EHR), a message would appear saying antibiotics are not indicated for this condition.
     
  • Accountable justification where clinicians had to enter in the EHR a justification for the antibiotic, thus making it a part of the patient's medical record.
     
  • Peer comparison where emails were sent to clinicians comparing their antibiotic prescribing rates to those with the lowest inappropriate prescribing rates.
A total of 248 clinicians located at 47 primary care practices in Boston and Los Angeles were observed over an 18-month period, with the results compared to their prescribing rates from the previous 18 months. Although decreases in prescribing rates were seen in all three behavioral interventions, accountable justification (from 23.2 percent to 5.2 percent) and peer comparison (19.9 percent to 3.7 percent) saw the largest decreases.
Study finds physician burnout increasing across specialties
Physician burnout is increasing and so is its severity, according to the "Medscape Lifestyle Report 2016: Bias and Burnout" conducted by Medscape. Medscape surveyed 15,800 physicians from more than 25 specialties. According to the survey, some of the top causes of burnout include having too many bureaucratic tasks, working long hours, and increasing computer work. An article from H&HN Daily breaks down the results of the survey. The article says hospitals are taking a number steps to help alleviate burnout of their physicians. These include providing scribes to help with administrative tasks so physicians can focus more on the patient, as well as creating wellness teams to give attention to those overworked physicians.
Collaborative announces consensus on core measure sets for certain clinicians
The Core Quality Measures Collaborative, a public-private effort to align and simplify quality measures for physicians and other clinicians, has reached consensus on core quality measures for certain primary and specialty care providers, the Centers for Medicare & Medicaid Services (CMS) and America's Health Insurance Plans recently announced. The seven measure sets apply to: accountable care organizations, patient-centered medical homes and primary care; cardiology; gastroenterology; HIV and Hepatitis C; medical oncology; obstetrics and gynecology; and orthopedics. CMS plans to use the notice and comment rulemaking process to implement the measures in public programs where appropriate and to eliminate redundant measures that are not part of the core measure set. CMS's draft plan for developing quality measures for the new Merit-based Incentive Payment System and alternative physician payment models also was informed by the core measure sets. Commercial health plans intend to implement the measures when contracts are renewed or allow changes to performance measures. The collaborative plans to add additional measures and measure sets in the future.
Increasing empathy through technology
To help doctors and patients better keep in touch, some hospitals are working with startups to automate empathy, according to a recent article from Kaiser Health News. The goal is not only to improve engagement, but also to help patients stick with their treatment and recovery regimens, increase patient satisfaction scores, and lower readmission rates. One such startup featured in the article is HealthLoop. Emails can be timed to coincide with a milestone in surgery prep or recovery, and doctors have the option to write their own content or use the company's suggested scripts, the article says. Doctors can access an online dashboard to check how their patients are progressing. Patients have the option to directly communicate with office staff, and their answers to questions from the emails might prompt a follow-up call from the doctor's office. According to the article, some organizations currently testing HealthLoop include the Cleveland Clinic, Kaiser Permanente-Southern California, and the University of California, San Francisco.
Improving care and outcomes for patients with chronic pain focus of next PLF webinar
Join the AHA's Physician Leadership Forum and the American Society of Health-System Pharmacists on Tuesday, Mar. 22 beginning at 3:00 p.m. ET to learn about improving care and outcomes for complex patients with chronic pain.
 
In this 60-minute webinar, presenters from Brigham and Women's Hospital will describe in detail a clinical pharmacy service that supports the management of chronic pain patients and the benefits these services provide to hospitals and health systems, including the challenges faced by providers in managing substance abuse. Participants will be able to:
  • Describe the clinical pharmacist service and how such services can be established
  • Describe the interprofessional collaboration and benefits to medical staff in effective and efficient management of their patients, and
  • Describe the opportunities organizations can realize in improved patient outcomes, including proactively addressing substance abuse issues that can arise in patient populations served.
To register for this complimentary webinar, click here.
HPOE to host webinar on combatting the opioid crisis
Join Hospitals in Pursuit of Excellence (HPOE) of the American Hospital Association Tuesday, Mar. 8 from 1:00-2:00 p.m. ET for a new webinar giving participants an in-depth look into how the Massachusetts Hospital Association, along with its Board and member hospitals, developed and launched one of the nation's most comprehensive and groundbreaking efforts to combat the opioid crisis.
 
Participants will learn how the movement gained momentum, task force formation, development and implementation of an innovative action plan including an overview of emergency departments prescribing guidelines adopted by all member hospitals, lessons learned and efforts moving forward.
 
Speakers: 
  • Peter J. Holden, president  and CEO at Beth Israel Deaconess Hospital-Plymouth
  • Patricia Noga, PhD, RN, MBA, NEA-BC, vice president of clinical affairs at Massachusetts Hospital Association
  • Steven M. Defossez, MD, EMHL, vice president of clinical integration at Massachusetts Hospital Association
This webinar is available free of charge, but advanced registration is required. To register, click here.
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